JP2008520338A - Rotary rehabilitation apparatus and method - Google Patents

Abstract

A rotary rehabilitation device is provided for rehabilitation of human limbs (including joints, associated muscles, tendons, ligaments). The device can be tailored to the person's needs based on the person's body size, injury type, and recovery plan. This device facilitates adjustment of the range of motion of the user's limbs in a cycling action by offsetting the movable lever from the fixed lever at multiple angles. As the user's limb moves in a circular path, the limb is involved in extension and flexion, causing movement in the joint formed by the user's joint.

Description

(Related application)
This application is a continuation-in-part of US patent application Ser. No. 10 / 687,207, filed Oct. 16, 2003. The above application is incorporated herein by reference.

(Background of the Invention)
(1. Field of the Invention)
The present invention relates generally to the field of exercise and rehabilitation, and more specifically to the user's limbs, including both arms and legs, actively engaging or passively participating in a cycling action. The present invention relates to an apparatus for providing selective adjustment of the range of motion of the apparatus.

(2. Explanation of related technology)
One of the most serious and most common movement injuries is to the knee, and according to published data, the degree is between one quarter and one third of all men and women every year However, there are ongoing reports of experiencing some type of knee injury. Each year, about 10.8 million people visit doctors just because of knee problems. The total estimated cost in the United States for all musculoskeletal states annually is $ 254 billion. Many human leg injuries require the use of rehabilitation exercises. Such injuries include injury to joints of human legs (eg, knees, hips), human joints (eg, total hip arthroplasty, total knee arthroplasty [THA, TKA]), ligaments associated with these joints or It may include replacement of tendons (eg, anterior cruciate ligament or medial ligament [ACL, MCL], or patella or quadriceps), or leg muscles (eg, Rectos or bigastric). Rehabilitation exercises are also often prescribed after surgery and are performed to further repair the damaged site of the user's limb.

  Major trunk injuries are also very common in the United States. Major trunk injuries include those that affect the shoulders and back. Since the shoulder joint is the most flexible joint in the human body, it can be easily damaged by accidentally exceeding the range of motion. The US Department of Labor estimates that 35% of all musculoskeletal injuries are major injuries. Because of shoulder injuries, more than 4 million visits to health care professionals each year. In addition, the US Department of Labor estimates that the average period of absence from work due to shoulder injury is 12 days. This represents an estimated $ 130 to $ 20 billion in work loss over time.

  One common rehabilitation exercise that has been recommended to improve muscle, ligament, and tendon strength after injury or surgery and endurance of the extremities is movement of cycling motion. As the human upper and lower limbs move in a circular path, motion is induced in the joints that form the shoulders and elbows or the waist and knees, respectively. However, for rehabilitation to be effective, there are other factors as well, tailored to the specific needs of the person based on, among other things, the size of the person's body, the type of injury, and the plan for recovery. You have to match. For example, if a surgical repair is made to a torn ACL in a person's leg, not only because of pain, but also at the beginning of the rehabilitation regimen, knee flexion or It is often desirable to limit extension. Similarly, for the shoulder, the doctor recommends limiting the shoulder movement to some degree much less than the full 360 degree ability of the shoulder until it recovers spontaneously and full rehabilitation occurs. obtain. Although cycle-type exercise machines are recommended for use in certain types of rehabilitation prescription plans, this type of machine is generally not easy to adjust for the range of motion of an individual limb. Furthermore, these machines are limited to standard pedal or handle arrangements, with one lever (handle or pedal) being offset 180 degrees around the hub from the other lever. However, there is a rehabilitation prescription plan in which a benefit in flexibility, strength, and / or durability is achieved by offsetting the lever or handle to another angle relative to passive range of motion, assisted active range of motion. Exists.

(Summary of Invention)
A rotary rehabilitation device is provided that allows selection of a range of motion for an upper limb and / or lower limb of a person engaging in a cycling action. Adjustable lever assembly allows rehabilitation following lower back, knee, shoulder and / or elbow disorders to be safer and more effective, reducing pain, increasing range of motion, soft tissue Further provide enhancement and systemic adjustment. The assembly includes a single movable lever and a flywheel that is rotatably mounted on a support and has a series of bores along its diameter. The movable lever or handle is releasably attached to the bore. In an exemplary arrangement that incorporates a cycle type exercise machine (eg, an ergometer), a rotary rehabilitation device sits on a seat, places its feet or hands on the levers, and distributes forces to those levers. As the user's foot or hand moves in a circular path, the limbs are involved in extension and flexion and movement of the articulation formed in the user's hip and knee joints or shoulder and elbow joints cause. The amount of movement of the joints of the limbs, and consequently the range of motion of these joints, can be controlled by mounting the lever with an appropriate bore on the flywheel. If it is desired to increase extension and flexion, the lever can be mounted with a bore farther from the axis of rotation of this flywheel. Conversely, if it is preferable to reduce the angle of extension and bending, the lever can be mounted with a bore closer to the axis of rotation of the flywheel.

  In one configuration, the movable lever is releasably mounted within the mounting bore of the flywheel while the other lever remains at full diameter. This configuration allows the range of motion for one limb to be adjustable and allows the range of motion for the other limb to be fixed. This allows more limited rehabilitation exercises for one limb (eg, an injured knee or shoulder) and more robust exercises for the other limb.

  In another aspect, the series of two or more bores has bores that extend over different diameters of the flywheel, and the movable lever can be mounted at various angles relative to the fixed lever about the axis of rotation. For example, the levers are aligned around the hub on a cycle-type exercise machine, typically 180 degrees from each other, while in rehabilitation prescription plans, the levers are placed at different angles to allow passive range of motion (“PROM”). ), Assisted active range of motion (“AAROM”), and active range of motion (“AROM”).

  The rotary rehabilitation device of the present invention provides an improved option for rehabilitation prescription planning when cycling or rotational action is effective in recovering from human limb injury. As the user recovers from his injury, including increased strength and flexibility of his limbs, the user can disengage the movable lever or handle and move differently with respect to his limbs when rotating the assembly. Can be newly installed in another bore that provides area.

  By quickly working PROM, AAROM, and AROM, the present invention reduces the time it takes to recover from limb injury, and includes range of motion, edema, proprioceptive sensation, return to unassisted walking activity, Further improve measurable outcomes such as initial functional independence measurement, strength, and adjustment, reduce overall inpatient and outpatient costs, accelerate return to professional and non-professional activities, and autonomous Significantly improve quality of life by accelerating return to life.

(Detailed description of the invention)
One rotary rehabilitation device 10 that provides a range of motion selection for one or both human legs 200 is shown in FIGS. Embodiments of a rotary rehabilitation device for rehabilitating a human upper limb are discussed in detail below. The rotary rehabilitation device 10 is shown incorporated in a cycle type exercise machine 100. The machine 100 includes a support 102 on which the apparatus 10 is rotatably mounted, and a seat 104 that is located at a distance from the support 102. In this arrangement, a human can sit on the seat 104, place his feet 204 on the levers 12a and 12b, force his levers 200 to push these levers, and the flywheel 14 at its center point 15 in a horizontal plane. Can rotate about an axis extending to

  The range of motion for each leg 200 can be adjusted by allowing the movable lever 12a to be repositioned along one or more diameters of the flywheel 14. The flywheel 14 has a bore 16 extending in a lateral direction parallel to the axis of rotation of the flywheel, and these bores are formed in a row along the diameter of the flywheel. As a result, the lever 12a can be removably mounted on one of these bores 16. In the embodiment of the rotary rehabilitation device 10 shown in FIGS. 1-4, the flywheel 14 has a series of two separate bores 16, each aligned along one diameter of the flywheel and orthogonal to each other. 5-7 illustrate an embodiment of a flywheel 14 that utilizes a non-linear configuration of a series of two bores. This non-linear configuration provides a separate choice for range of motion and utilizes linearly arranged bore holes to experience certain patients who have experienced difficulties in achieving their own range of motion improvement. Is very beneficial against. FIG. 6 reveals an embodiment of the flywheel 14 that utilizes a continuous ring 19 on the outer peripheral wall of the flywheel. FIG. 7 conversely utilizes a discontinuous outer ring 17. Both embodiments include additional mass in the outer ring of the flywheel 14 to increase the inertia of the flywheel 14 and improve the benefits associated with passive rotation. By increasing the mass of the flywheel on the outer peripheral wall of the flywheel, the desired rotational speed can be maintained even if the energy input from the user's limbs is reduced.

  1 to 4, the movable lever 12 a is attached to the flywheel 14, and the fixed lever 12 b is attached to a crank 18 that extends radially from the hub 20. The flywheel 14 is mounted on the hub 20 so as to be rotatable at the center point 15. This configuration allows both lever adjustment along the flywheel 14 toward or away from the center point 15 and lever adjustment along the concentric circle with the flywheel 14 about the center point 15. To. Thus, the lever 12a can have an offset angle of 90 degrees, 180 degrees, or 270 degrees around the rotational axis of the flywheel with respect to the fixed lever 12b.

  8-12 show further details of the flywheel 14 and the mounting of the hub 20. The flywheel 14 includes a circular disk 22 having opposed first and second planes 24, 26 and an outer peripheral wall 28, and a circumferential ring 30 fixed around the outer peripheral wall 28. The ring 30 can be press fit over the disk outer wall 28 or it can be attached to the outer wall 28 with fasteners or adhesive. A set of first notches 32 is formed to align with each row of bore series 16 along an inner end 34 of ring 30 adjacent to first plane 24 of the disk. These notches 32 allow the extension of the brace member 36 over the disk plane 26 on the diameter of the ring 30 to fit easily with the notches 32. A second set of notches 38 having a curved profile is formed along the inner end 34 of the ring adjacent the second plane 26 of the disk. The notch 38 provides additional clearance so that the lever 12 fits in close proximity to the second plane 26 when the movable lever 12a is mounted in the bore 16 furthest from the center point 15.

  Depending on the functionality desired in the cycle type exercise machine 100, the flywheel 14 may be designed to have a relatively large or relatively small moment of inertia. A large moment of inertia of the flywheel 14 requires more peddling force to accelerate it to a given speed, but also the flywheel 14 is more susceptible to speed changes. It can also cause good resistance, resulting in a smoother “steady state” cycling. This can be desirable for certain types of rehabilitation exercises. Generating a higher moment of inertia is done by making the flywheel 14 heavier and / or moving more weight of the flywheel away from the circumferential ring 30.

The flywheel 14 is attached to the hub 20 by inserting a fastener 39 into the bore 16 of the disk 22 that forms the center point 15 of the flywheel 14 and via a coupling 40 to secure the hub 20. .
. In particular, the fastener 39 extends into a receiving bore 42 formed in a stem 44 that is rotatably mounted within the body 46 of the hub 20. In this arrangement, the hub body 46 rests on the support 102 while the hub stem and attached flywheel 14 rotate relative to the hub body 46. The hub 20 is preferably mounted close to the first plane 24 on the side of the flywheel 14 opposite the movable lever 12a.

  In addition to controlling the moment of inertia of the flywheel 14 in conjunction with known cycle type exercise machines, the overall resistance to rotation of the flywheel 14 is controlled by the user. It can be controlled to increase the amount of work to be performed. For example, frictional resistance can be incorporated into the design of the hub 20 to require some force to overcome static and dynamic friction within the hub 20 as the stem 44 rotates relative to the hub body 46. Alternatively, for example, a friction surface (not shown) that is a brake may selectively engage the circumferential ring 30 to generate static and dynamic friction.

  13 to 17 show components of the movable lever 12a. The lever body 48 has opposing surfaces 49 on which the user's feet are placed and a bore 50 that extends through the body 48 from the outer surface 52 toward the inner surface 54. A chamfer 56 is also formed at the bore entrance of the outer surface 52. The sleeve 58 has a first end 60 and a second end 62 and is inserted into the bore 50 as shown in FIG. 15 so that the second end 62 extends outside the lever inner surface 54. Configured. The pin 64 is inserted into the sleeve 58 and touches the shank 66 extending outside the second end 62 and the first end 60 and the beveled region 72 so as to match the chamfer 56. And a collar 68 having a concentric base 70 configured to fit. A protrusion 74 is formed on the shank 66 near the end far from the collar 68 and the pin 64 fits frictionally within one bore 16 of the flywheel 14 to secure the lever body 48 to that bore. . If sufficient tension is applied to the lever body 48 away from the flywheel 14, the protrusion 74 can be removed from the friction fit in the bore 16 and repositioned to another bore 16 as desired. The lever body 48 and the sleeve 58 are also rotatable about the pin 64 so that when the flywheel 14 rotates, one of the pedaling surfaces 49 can be moved by the user to the pedaling surface 49 via cycling motion. The position is maintained so that force can continue to be applied with the foot 204 of the foot.

  In an alternative embodiment shown in FIG. 18, a standard bicycle pedal 330 can be used with a quick release adapter 332. The standard bicycle pedal 330 is a bicycle pedal with a clip or handgrip and its utilization with a quick release adapter 332 is highly desirable in this application. This is because if a pedal is damaged or simply worn, it can be purchased quickly and cheaply at various commercial retailers. Further, it is important from the viewpoint of rehabilitation setting that the lever is easily removed and repositioned. This is because many patients have reduced strength in such situations due to injury or debilitating diseases that limit the amount of force they can apply. While the application of the bicycle pedal of the present invention is described in more detail below, it should be understood that other devices for applying force from the user's limbs are also contemplated. For example, a handgrip utilized by the user's hand instead of a foot pedal may also be considered by the present invention.

  FIG. 18 shows the situation where the standard bicycle pedal 330 approaches and engages the quick release adapter 332. The quick release adapter 332 consists of a machined bushing 336 having a beveled edge 338, a first shaft 340 having a diameter D1, and a second shaft 342 having a diameter D2. The slot 344 is machined into the bushing 336, in which a spring loaded locking lever 346 is placed. The portion of the locking lever 346 proximate to the beveled edge 338 is biased upward away from the center of the shaft 340, 342 via the force of the spring 348. The locking lever 346 is placed and held in the slot 344 with the assistance of the roll pin 350, which roll pin 350 passes through the holes 352, 354 in the second shaft 342 and the hole 353 in the locking lever 346 itself. Inserted. The roll pin 350 functions as an axis of rotation about which the locking lever 346 can rotate an amount sufficient to facilitate removal of the quick release adapter 332 from the flywheel 14.

  As shown in FIG. 19, the locking lever 346, in its preferred embodiment, utilizes a push pad 356 and is positioned in front of the roll pin 350 so that finger or hand pressure P overcomes the force of a spring 348 (not shown). To be granted. This spring 348 is also located in front of the roll pin, below the locking lever 346 in the slot 344. The pressure P rotates the locking lever 346 downward about the roll pin 350. As shown in FIG. 18, when the locking lever shaft 358 extends from the push pad 356 and the locking lever 346 is located in the slot 344, the surface 360 of the locking lever shaft 358 is outside the first shaft 340. It should be close to the diameter D1 or slightly smaller. Maintaining the locking lever shaft 358 closely with the outer shaft diameter D1 allows the quick release adapter 332 to be inserted into the bore 14 without interference. As shown in FIG. 18, there is a locking pad 362 adjacent to the shaft 358 and opposite the push pad 356. The locking pad 362 utilizes the locking surface 364 and is inserted into the bore 14 and passes through the bore 14 to secure the quick release adapter 332 in place and prevent the quick release adapter 332 from accidentally coming out. . The top surface 366 of the locking pad 364 is beveled with the same slope as the beveled edge 338, which makes it easier to insert the quick release adapter 332 in place through the bore 16. When the locking pad 362 is fully inserted through the bore, the spring 348 drives the entire locking pad 362 upward, including the locking surface 364.

  As shown in FIG. 21, the second shaft 342 having a diameter D 2 includes an internal thread 370 for inserting a standard bicycle pedal 330. A preferred thread is a standard 9/16 inch with 20 threads per inch. However, it should be understood that other thread configurations are also contemplated.

  In operation, the bicycle pedal 330 is threaded into the internal thread 370 of the quick release adapter 332. The user then inserts the end of the quick release adapter 332 into the desired flywheel bore 16 using the beveled edge 338 to the point where the locking surface 364 of the locking pad 362 reaches the opposite side of the flywheel 14. To do. 20 and 22, once the locking surface 364 reaches the opposite side of the flywheel 14, the force of the spring 348 is applied to the tip 372 measured from the centerline CL of the shaft 340 of the locking surface 364. Push the locking surface 364 upwards to a point exceeding the dimension D1. When the tip 372 of the locking surface 364 extends beyond D1, the quick release adapter 332 cannot be withdrawn from the bore 16 unless the locking surface tip 372 is at least lower than D1. This is because the tip 372 interferes with the opposite surface of the flywheel 14 when attempting to pull out the quick release adapter 332. In order to pull out the quick release adapter 332, the user must apply pressure P to the push pad 356 in front of the roll pin 350. Thereby, the locking lever 346 rotates downward in front of the roll pin 350. Once the tip 372 of the locking surface 364 is lowered from the centerline CL to a point below D1, the entire assembly comprising the quick release adapter and the bicycle pedal 330 can be withdrawn from the bore 16 of the flywheel 14 so that the user can By repeating the outlined steps, it can be repositioned as desired.

  FIGS. 23-27 show exemplary orientations for the rotary rehabilitation device 10. Here, the movable lever 12a is shown attached to one of the outermost bores 16 in the radial direction of the flywheel 14. In FIG. 28, an embodiment of a flywheel 14 having two linear bore series 16 is shown. Each concentric dotted line on the flywheel disc 22 connecting the bores 16 on different rows represents a predetermined distance from the center point 15 (ie, the point of rotation) of the flywheel 14, for example, 1 inch. Represent. Accordingly, the angle of adjustment achieved by mounting the movable lever 12a with one specific bore 16 can be quickly determined. FIG. 29 shows another flywheel 14 embodiment having a series of four bores 16 with each row rotated 45 degrees relative to each other. For example, other bore arrangements of 30 degrees and 60 degrees may also be considered as needed depending on the needs of the user's limbs. This arrangement allows finer tuning of the angular offset between the movable lever 12a and the fixed lever 12b, which may be desirable in certain rehabilitation regimes.

  FIGS. 30 and 31 illustrate a single post having a curved edge 76 that contacts the coupling 40 on the end opposite the notch 32 of the circumferential ring 30 and an edge 78 that is beveled on both sides of the curved edge 76. Member 36 is shown. Each beveled edge 78 of one strut member abuts a beveled edge 78 of another strut member 36 extending along an adjacent row of bore series 16. 32 to 34 show the coupler 40 in detail. A cavity 80 is formed in the cylindrical coupler 40 and is shaped to receive the stem 44 of the hub 20. Also, as shown in FIG. 10 together with FIGS. 32 to 34, the bore extends from the cavity 80 via the coupler 40 and has a length sufficient for the fasteners 39 to reach the stem 44. Thus, the coupler 40 provides an interface for mounting the flywheel 14 more securely against rotation about the hub body 46.

  The motion of a leg 200 of a person utilizing the rotary rehabilitation device 10 of the present invention is shown in FIGS. 35-35 showing the hip joint 206, upper leg 208 (eg, femur), knee joint 210, and lower leg 212 (eg, tibia). 36 is simulated. 35 and 36, the fixed lever 12b is at a radial distance (for example, 6 inches) from the rotation axis of the flywheel 14, which is the radial distance from the rotation axis of the movable lever 12a (for example, 1). Considerably larger than inch). This provides a relatively large range of motion for the user's leg to pedal the fixed lever 12b while providing a relatively small range of motion for the leg to rotate the movable lever 12a. In this configuration, the movable lever 12a changes the angle formed between the lower leg 212 and the tangent extension of the upper leg 208, and the remaining angle between 67 degrees and 56 degrees is 11 degrees. Limit to.

  This rehabilitation prescription plan can be proposed to limit stress on the hip 206 or knee 210, for example, when the user should not bend his leg to a predetermined angle. Conversely, in FIGS. 37 and 38, the movable lever 12a and the fixed lever 12b are the same radial distance (for example, 6 inches) from the rotation axis of the flywheel 14. Therefore, when pedaling with this device 10, both legs of the user enter a large range of motion. In the embodiment of FIGS. 37 and 38, the angle formed between the lower leg 212 and the tangential extension of the upper leg 208 by the movable lever 12a can be cycled between 6 degrees and 88 degrees. Become. This large range of rehab prescription plan allows greater flexion and extension than the configuration of FIGS. 35 and 36, resulting in greater movement of the hip and elbow joints. Thus, the embodiment of FIGS. 37 and 38 provides flexibility and strength of the injured joint (eg, the user's ACL or total knee arthroplasty (TKA)) during the late stage of the injury or during rehabilitation after surgery. May be preferred when

  The embodiment of the rotary rehabilitation device 218 shown in FIG. 39 is for upper limbs including shoulders, arms, and elbows, allowing the range of motion for each arm 220 to be adjusted is one or more of the flywheel 224. This is accomplished by having a movable hand lever 222 that can be displaced along its diameter. The flywheel 224 has a series 226 of bores, either linear or non-linear as described above, depending on the needs of the user's limbs, which extend laterally parallel to the axis of rotation of the flywheel. Form a row along the diameter of the flywheel. As a result, the hand lever 222 can be removably attached to one of the bores 226. In the embodiment of the rotary rehabilitation device 218 shown in FIG. 39, the flywheel 224 has two separate bore series 226, each aligned along the flywheel diameter. Embodiments revealing a series of bores arranged non-linearly on the flywheel, as previously described and illustrated in FIGS. 5-7, are also contemplated by the present invention.

  40 to 44 show a fixed hand lever for use on the flywheel 224 shown in FIG. The fixed hand lever is mounted on a flywheel 224 that is rotatably mounted at a center point 228. With this configuration, lever adjustment along the diameter of the flywheel 224 toward the center point 228 or along the diameter of the flywheel 224 away from the center point 228, and lever adjustment along the concentric circle with the flywheel 224 around the center point 228 And enable both. Thus, the offset angle of the hand lever 222 with respect to the fixed hand lever around the rotation axis of the flywheel can be 30, 45, and 90 degrees, or a multiple thereof.

  40-44 show the components of the movable hand lever 222. FIG. The hand lever body 248 can be tubular in shape or other configuration that is easily adapted to be grasped by a human hand. The hand lever has a bore 250 that extends through the body 248 from the outer surface 252 to the inner surface 254. A bore chamfer 256 is also formed at the bore entrance of the outer surface 252. The sleeve 258 has a first end 260 and a second end 262, and the second end 262 extends outside the lever inner surface 254 and is configured to be inserted into the bore 250. The pin 264 is inserted into the sleeve 258 and contacts the shank 266 extending outside the second end 262 and the beveled region 272 and fits the chamfer 256. And a collar 268 having a concentric base 270 configured to. A protrusion 274 is formed on the shank 266 near the end far from the collar 268 and the pin 264 fits frictionally within one bore 226 of the flywheel 224 and secures the hand lever body 248 to that bore. . If sufficient tension is applied to the hand lever body 248 away from the flywheel 224, the protrusion 274 is removed from the friction fit within the bore 226 and repositioned to another bore 226 as desired. obtain. The hand lever 248 and sleeve 258 are also rotatable about the pin 264 so that when the flywheel 224 rotates, the lever body and sleeve also rotate so that the user can The sleeve can continue to be applied with force through the rotational motion of his hands and arms.

  The use of the quick release adapter 332 referenced above is similarly contemplated for embodiments directed to the upper limb. An alternative to the bicycle pedal shown in FIG. 18 is a handgrip or other similar device that is gripped by the upper limb.

  Numerous changes and modifications can be made by those skilled in the art without departing from the spirit and scope of the invention. Therefore, it should be clearly understood that the illustrated embodiments are for illustrative purposes only and are not intended to limit the invention as defined by the following claims. Thus, the following claims not only literally include what is indicated by the claims, but also the same results, even if they are not equivalent to what is shown and described in the above description. Should be read to include all equivalent elements that perform substantially the same function in substantially the same manner.

FIG. 1 is a right side elevational view of a rotary rehabilitation apparatus of the present invention incorporating a cycle type exercise machine. FIG. 2 is a perspective view of the rotary rehabilitation apparatus of the present invention incorporating a cycle type exercise machine. FIG. 3 is a top plan view of the rotary rehabilitation apparatus of the present invention incorporating a cycle type exercise machine. FIG. 4 is a front elevational view of the rotary rehabilitation apparatus of the present invention incorporating a cycle type exercise machine. FIG. 5 is a side elevation view of an embodiment of a flywheel having a non-linearly configured borehole. FIG. 6 is a side elevation view of an embodiment of a flywheel having an additional mass of continuous ring applied to the outer peripheral wall of the flywheel to increase the inertia of the flywheel, with a flywheel having a non-linearly configured borehole. It is. FIG. 7 is a side elevation of an embodiment of a flywheel with a non-continuous ring additional mass applied to the outer peripheral wall of the flywheel to increase the inertia of the flywheel, with a flywheel having a non-linearly configured borehole FIG. FIG. 8 is a left perspective view of a flywheel having a borehole linear configuration and mounted with a hub. FIG. 9 is a right perspective view of the flywheel of FIG. FIG. 10 is an exploded view of a flywheel mounted with a hub. FIG. 11 is a front elevation view of the flywheel of FIG. 12 is a right side elevational view of the flywheel of FIG. FIG. 13 is a perspective view of an embodiment of a pedal lever assembly. FIG. 14 is an exploded view of an embodiment of a pedal lever assembly. FIG. 15 is a top plan view of an embodiment of a pedal lever assembly. FIG. 16 is a left side elevational view of an embodiment of a pedal lever assembly. FIG. 17 is a front elevation view of an embodiment of a pedal lever assembly. FIG. 18 is an exploded view of a slotted bushing including a locking lever and a standard bicycle pedal. FIG. 19 is a perspective view of a slotted bushing with a locking lever in place. FIG. 20 is a cross-sectional front view of a slotted bushing including a locking pad and a locking surface. FIG. 21 is a side view of the slotted bushing in which the thread for connecting to the pedal is indicated by phantom lines. FIG. 22 is a side view of the quick release adapter inserted through the flywheel, with the locking surface positioned against the flat surface of the flywheel. FIG. 23 is a left perspective view of the rotary rehabilitation device, showing a lever that engages with one of the bores of the flywheel and a flywheel that is rotatably mounted by a hub. FIG. 24 is a right perspective view of the rotary rehabilitation device, showing a lever mounted with a flywheel and a hub mounted with the flywheel. FIG. 25 is a top view of the rotary rehabilitation device, showing a lever mounted with a flywheel and a flywheel mounted with a hub. FIG. 26 is a front elevation view of the rotary rehabilitation device of FIG. 25. FIG. 27 is a right elevation view of the rotary rehabilitation device of FIG. 25. FIG. 28 is a side elevational view of one embodiment of a flywheel disc showing a linear configuration of bores along two diameters of the flywheel. FIG. 29 is a side elevational view of another embodiment of a flywheel disc showing a linear bore configuration along the four diameters of the flywheel. FIG. 30 is a side elevational view of one strut member of the flywheel. FIG. 31 is a front elevation view of the strut member of FIG. FIG. 32 is a rear elevation view of a coupling for mounting a hub with a flywheel. FIG. 33 is a side elevational view of the coupling of FIG. 34 is a front elevation view of the coupling of FIG. FIG. 35 schematically shows the leg member when the foot is placed on the first position of rotation on the lever of the rotary rehabilitation device. FIG. 36 schematically shows the leg member when the foot is placed on the second position of rotation on the lever of the rotary rehabilitation device. FIG. 37 shows a leg member when the foot is placed on the first position of rotation on the lever of the rotary rehabilitation device, one of the levers being located on the flywheel different from the lever of FIGS. 35 and 36. Is shown schematically. FIG. 38 shows the leg member when the foot is placed on the second position of rotation on the lever of the rotary rehabilitation device, one of the levers being located on the flywheel different from the lever of FIGS. Is shown schematically. FIG. 39 is a right side elevational view of a rotary rehabilitation device configured for movement of the upper limbs of the shoulder and / or elbow. FIG. 40 shows a perspective view of the lever assembly of the rotary rehabilitation apparatus of the present invention. FIG. 41 is an exploded perspective view of the lever assembly of the rotary rehabilitation apparatus of the present invention. FIG. 42 shows a right side elevational view of the lever assembly of the rotary rehabilitation apparatus of the present invention. FIG. 43 shows a top plan view of the lever assembly of the rotary rehabilitation apparatus of the present invention. FIG. 44 shows a front elevation view of the lever assembly of the rotary rehabilitation apparatus of the present invention.

Claims (30)

A device for providing an adjustable joint range of motion to a joint corresponding to a user's limb,
A flywheel comprising a disk having opposing substantially flat surfaces and an outer peripheral wall, the flywheel being rotatably mounted on an axial rotation support, the outer periphery of the flywheel A first series of spaced bores exhibiting a non-linear configuration from a portion adjacent to the wall to an opposing portion on the diameter of the outer peripheral wall, the non-linear configuration of the bore sequence being a center point of the flywheel Extending through, a flywheel,
A first lever releasably mounted to one of the first spaced bore series and repositionable from one bore to another, wherein the first lever is A first lever extending outwardly from one of the substantially flat surfaces of the flywheel;
A seat that is placed at a distance from the flywheel so that a user seated in the seat can engage the first lever and the limb and rotate the lever;
The first lever is placed on the first lever by repositioning the first lever from one bore of the first bore series to another of the first bore series. An apparatus for changing a path of motion for a user's limb, thereby changing the range of motion of the joint of the user's joint with respect to the corresponding limb.   A series of second spaced bores exhibiting a non-linear configuration from a portion of the flywheel adjacent to the outer peripheral wall to an opposing portion on the diameter of the outer peripheral wall, wherein the second spaced bore series The apparatus of claim 1, wherein the configuration further comprises a second spaced bore series that bisects the configuration of the first bore series at a substantially center point of the flywheel. The flywheel is rotatably mounted on a hub connected to the support;
The device is a second lever that is releasably attached to either the first or second spaced bore series and is repositionable from one bore to another. The second lever, like the first lever, extends outwardly from the opposing substantially flat surface of the flywheel, so that the user can 3. The apparatus of claim 2, further comprising a second lever capable of rotating the flywheel by imparting a force on the lever and the second lever. The first lever is
A bore extending laterally from the inner lever side to the outer lever side facing the inner lever side;
A sleeve configured to fit within the lever bore;
A pin insertable through the sleeve on the outer lever side and extending away from the inner lever side, the pin engaging a horizontally aligned bore of the flywheel The apparatus according to claim 1, further comprising: a pin having a portion. The first lever is a slotted bushing configured to be operable with a pivotal locking lever, the locking lever facing a spring-biased push pad, a central shaft, and the push pad. And further comprising a slotted bushing, further comprising a locking pad arranged in
The slotted bushing is removably coupled to an assembly in which the user's limb applies force, and the slotted bushing is inserted through the bore, thereby applying pressure to the push pad. Until the locking pad locking surface is secured against inadvertent release from the flywheel by positioning the locking surface of the locking pad against the opposing substantially flat surface of the flywheel until The apparatus of claim 1, wherein the locking surface is lowered to facilitate removal of the slotted bushing from the bore.   The apparatus of claim 1, wherein the flywheel further comprises means for increasing the inertia of the flywheel. The means for increasing the inertia of the flywheel is:
A ring configured to be operable to receive the flywheel at the outer peripheral wall of the disc, the ring having an inner edge;
The apparatus of claim 6, further comprising: a strut member extending across one of the flat surfaces of the disc and spanning the inner diameter of the ring. An adjustable lever assembly for a rehabilitation device, the adjustable lever comprising:
A flywheel rotatably mounted on an axial support for rotation, the flywheel from an opposing flat surface, an outer peripheral wall, and a portion of the flywheel adjacent to the outer peripheral wall; A disc having a series of first spaced bores exhibiting a non-linear configuration into opposing portions on the diameter of the outer peripheral wall, the non-linear configuration of the series of bores passing through a center point of the flywheel A flywheel that extends,
A first lever releasably mounted on one of the first series of bores, the first lever extending outwardly from the substantially flat surface of the flywheel; A device comprising: a first lever extending.   A series of second spaced bores exhibiting a non-linear configuration from a portion of the flywheel adjacent to the outer peripheral wall to an opposing portion on the diameter of the outer peripheral wall, wherein the second spaced bore series 9. The apparatus of claim 8, wherein the configuration further comprises a second spaced bore series that bisects the first bore series configuration substantially at the center of the flywheel. The flywheel is rotatably mounted on a hub connected to the support;
The device is a second lever that is releasably attached to either the first or second spaced bore series and is repositionable from one bore to another. The second lever, like the first lever, extends outwardly from the opposing substantially flat surface of the flywheel, so that the user can 9. The apparatus of claim 8, further comprising a second lever capable of rotating the flywheel by imparting a force on the lever and the second lever.   Each bore of the first spaced bore series extends a predetermined range from a center point of the flywheel, and a corresponding bore from the second spaced bore series extends the same range. 9. The apparatus according to 9.   A first plane extending through each bore of the first series of bores and the center point of the flywheel; the corresponding bore from the second series of bores; and the center point of the flywheel; 12. The apparatus of claim 11, wherein the intersection with the second plane extending through the angle defines one angle of the group consisting of 45 degrees, 60 degrees, and 90 degrees. The first lever is
A bore extending laterally from the inner lever side to the outer lever side facing the inner lever side;
A sleeve configured to fit within the lever bore;
A pin insertable through the sleeve on the outer lever side and extending away from the inner lever side, the pin engaging a horizontally aligned bore of the flywheel The apparatus according to claim 8, further comprising a pin.   The apparatus of claim 8, wherein the flywheel further comprises means for increasing the inertia of the flywheel. The means for increasing the inertia of the flywheel is:
A ring having a mass and configured to be operable to receive the flywheel at the outer peripheral wall of the disc, the ring having an inner edge;
The apparatus of claim 14, further comprising: a strut member extending across one of the flat surfaces of the disc and spanning the inner diameter of the ring.   The strut member comprises a plurality of elongate plates having a curved facing surface, the flywheel is rotatably mounted on a hub, and the curved facing surface of each elongate plate contacts the hub. 15. The apparatus according to 15. The first lever is a slotted bushing configured to be operable with a pivotal locking lever, the locking lever facing a spring-biased push pad, a central shaft, and the push pad. And further comprising a slotted bushing, further comprising a locking pad arranged in
The slotted bushing is removably coupled to an assembly in which the user's limb applies force, and the slotted bushing is inserted through the bore, thereby applying pressure to the push pad. Until the locking pad locking surface is secured against inadvertent release from the flywheel by positioning the locking surface of the locking pad against the opposing substantially flat surface of the flywheel until 9. The apparatus of claim 8, wherein the locking surface is lowered to facilitate removal of the slotted bushing from the bore. A method of selectively adjusting a joint range with respect to a joint of a user's limb engaged in a cycling action,
Providing a seat on which a user can sit;
Providing a flywheel rotatably mounted on a support spaced from the seat, the flywheel being configured to rotate about an axis, the flywheel comprising: A series of first spaced bores showing a configuration from a portion adjacent to the outer peripheral wall to an opposing portion on the diameter of the outer peripheral wall, the configuration of the bore series being a center point of the flywheel Extending through the steps;
Providing a lever configured to releasably attach to one of the bores of the flywheel;
When the user's limb is placed on the lever and force is applied to the lever, the lever is mounted on one particular bore of the flywheel and the user's limb is attached to each of the user's limbs. Selecting a desired joint motion of the joint.   The method of claim 18, wherein the spaced bore configuration is a linear configuration extending from a portion of the outer peripheral wall through a center point of the flywheel to an opposing portion on the diameter of the outer peripheral wall.   The method of claim 18, wherein the spaced bore configuration is a non-linear configuration extending from a portion of the outer peripheral wall through a center point of the flywheel to an opposing portion on the diameter of the outer peripheral wall. A device for providing an adjustable joint range of motion to a joint corresponding to a user's limb,
A flywheel comprising a disk having opposing substantially flat surfaces and an outer peripheral wall, the flywheel being rotatably mounted on an axial rotation support, the outer periphery of the flywheel A series of first spaced bores exhibiting a linear configuration from a portion adjacent to a wall to an opposing portion on the diameter of the outer peripheral wall, the linear configuration of the bore sequence being a center point of the flywheel Extending through, a flywheel,
A first lever releasably attached to one of the first spaced bore series and selectively repositionable from one bore to another, the first lever A first lever extending outwardly from one of the substantially flat surfaces of the flywheel;
A seat, wherein a user sitting in the seat can engage the first lever and the limb and is placed at a distance from the flywheel so that the lever can be rotated. ,
By repositioning the first lever from one bore of the first series of bores to the other, the path of motion for the user's limb placed on the first lever is A device that changes and thereby changes the range of motion of the user's joint associated with the corresponding limb.   A series of second spaced bores exhibiting a linear configuration from a portion adjacent to the outer peripheral wall of the flywheel to an opposing portion on the diameter of the outer peripheral wall, the second spaced bore series; 24. The apparatus of claim 21, wherein the configuration further comprises a second spaced bore series that bisects the first bore series configuration at a substantially center point of the flywheel. The flywheel is rotatably mounted on a hub connected to the support;
The device is a second lever that is releasably attached to either the first or second spaced bore series and is repositionable from one bore to another. The second lever, like the first lever, extends outwardly from the opposing substantially flat surface of the flywheel, so that the user can 24. The apparatus of claim 21, further comprising a second lever capable of rotating the flywheel by applying a force on the lever and the second lever. The first lever is
A bore extending laterally from the inner lever side to the outer lever side facing the inner lever side;
A sleeve configured to fit within the lever bore;
A pin insertable through the sleeve on the outer lever side and extending away from the inner lever side, the pin engaging a horizontally aligned bore of the flywheel The apparatus of claim 21, further comprising: a pin having a portion. The first lever is a slotted bushing configured to be operable with a pivotal locking lever, the locking lever facing a spring-biased push pad, a central shaft, and the push pad. And further comprising a slotted bushing, further comprising a locking pad arranged in
The slotted bushing is removably coupled to an assembly in which the user's limb applies force, and the slotted bushing is inserted through the bore, thereby applying pressure to the push pad. Until the locking pad locking surface is secured against inadvertent release from the flywheel by positioning the locking surface of the locking pad against the opposing substantially flat surface of the flywheel until The apparatus of claim 21, wherein the locking surface is lowered to facilitate removal of the slotted bushing from the bore.   The apparatus of claim 21, wherein the flywheel further comprises means for increasing the inertia of the flywheel. The means for increasing the inertia of the flywheel is:
A ring configured to be operable to receive the flywheel at the outer peripheral wall of the disc, the ring having an inner edge;
27. The apparatus of claim 26, further comprising: a strut member extending across one of the flat surfaces of the disc and spanning the inner diameter of the ring. A device for providing an adjustable joint range of motion to a joint corresponding to a user's limb,
A flywheel comprising a disk having opposing substantially flat surfaces and an outer peripheral wall, the flywheel being rotatably mounted on an axial rotation support, the flywheel A first series of spaced bores showing a configuration from a portion adjacent to the outer peripheral wall to an opposing portion on the diameter of the outer peripheral wall, the configuration of the bore series having a center point of the flywheel A flywheel extending through,
A first lever releasably mounted on one of the first spaced bore series and repositionable from one bore to another, the first lever comprising: A first lever extending outwardly from one of the substantially flat surfaces of the flywheel;
A seat that is placed at a distance from the flywheel so that a user seated in the seat can engage the first lever and the limb and rotate the lever;
By repositioning the first lever from one bore of the first series of bores to the other, the path of motion for the user's limb placed on the first lever is A device that changes and thereby changes the range of motion of the joint of the user's joint relative to the corresponding limb. The first lever is
A bore extending laterally from the inner lever side to the outer lever side facing the inner lever side;
A sleeve configured to fit within the lever bore;
A pin insertable through the sleeve on the outer lever side and extending away from the inner lever side, the pin engaging a horizontally aligned bore of the flywheel 30. The apparatus of claim 28, further comprising a pin having a portion. The first lever is a slotted bushing configured to be operable with a pivotal locking lever, the locking lever facing a spring-biased push pad, a central shaft, and the push pad. And further comprising a slotted bushing, further comprising a locking pad arranged in
The slotted bushing is removably coupled to an assembly in which the user's limb applies force, and the slotted bushing is inserted through the bore, thereby applying pressure to the push pad. Until the locking pad locking surface is secured against inadvertent release from the flywheel by positioning the locking surface of the locking pad against the opposing substantially flat surface of the flywheel until 29. The apparatus of claim 28, wherein the locking surface is lowered to facilitate removal of the slotted bushing from the bore.

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